Handshake Ban to Curb Hospital Infections

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Hospital-acquired infections are a serious and potentially life-threatening problem in hospitals, and the unwashed hands of healthcare workers are often to blame. One way to limit the spread of germs and reduce the transmission of disease at medical facilities is to establish handshake-free zones, according to an UCLA study.

"We are trying to do everything to minimise hospital-acquired infection except for the most obvious and easiest thing to do in my opinion, which is to stop shaking hands," says Dr. Mark Sklansky, professor of paediatrics at the David Geffen School of Medicine at UCLA and leader of the study.

The UCLA team launched a six-month experiment to try out the no-handshake zone idea. They picked a place where patients are especially vulnerable – the neonatal intensive care unit. Infections among infants can cause them pain, prolong their stay in NICU, require more medications and even put them at risk of dying.

The anti-handshake experiment took place at two of UCLA's NICUs, in Westwood and Santa Monica. Starting in 2015, Sklansky and his colleagues explained to the staff and families the purpose of handshake-free zones and posted signs designating the new zones. The signs feature two hands gripping each other inside a circle with a blue line through it, and the words: "To help reduce the spread of germs, our NICU is now a handshake-free zone. Please find other ways to greet each other." The team didn't ban handshakes outright. They suggested other options: a fist bump. A smile. A bow. A wave. A non-contact Namaste gesture.

This spring the UCLA team published the findings of a survey on their handshake-free zone experiment in the American Journal of Infection Control. They found that establishing such zones is possible and can reduce the frequency of handshakes. They didn't measure whether avoiding handshakes actually reduced the rate of infections, but Prof. Sklansky said he hopes to answer that question in a future study.

While their formal experiment has been completed, the signs in the NICUs are still in place and doctors and nurses still discourage handshakes.

Up to now, there is no data showing that reducing handshakes can limit hospital infections. A previous study reported however that bumping fists was more hygienic than shaking hands.

Moreover, some infectious-disease specialists believe healthcare workers don't need to stop shaking hands. They just need to scrub better. "The problem isn't the handshake: it's the hand-shaker," Herbert Fred, a Houston physician, wrote in a 2015 editorial in the Texas Heart Institute Journal.

Neonatologist Joanna Parga, who was part of UCLA's handshake-free survey, said she liked the idea when she first heard about it but wasn't convinced it would work. Shaking hands is "so ingrained in our culture," and it is how many doctors connect with patients, she said.

As part of the UCLA survey, Dr. Sklansky's team asked staff and parents what they thought of the new handshake-free zones. It was found that the majority of healthcare workers supported the idea – especially medical school students and nurses. Male doctors were the most resistant to giving up the handshake, partly because they weren't convinced it was necessary to prevent infections. Notably, patients' families were universally supportive of the handshake-free zone.

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healthcare workers, hospital infections, Handshake Ban, handshake-free zones
Hospital-acquired infections are a serious and potentially life-threatening problem in hospitals, and the unwashed hands of healthcare workers are often to blame. One way to limit the spread of germs and reduce the transmission of disease at medical facil

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